This is a competing renewal application to conduct theoretically-driven research to determine the course and predictors of mental health, social, and physical health outcomes in a cohort of children with cancer and their parents. We have been following a sample of 258 children (ages 5 to 17-years at entry into the study) from near the time of their cancer diagnosis over the first year after their diagnosis with a very high retention rate. By the end of this grant period we will have collected 3 waves of data including observations, interviews and questionnaires and we now propose to collect 2 additional waves of data, including direct observations of parent-child interactions, up to 5 years after diagnosis. Child and their parents completed measures about sources of cancer-related stress, how they cope with cancer, standardized indicators of distress and mental health problems, and they participated in video recorded observations. We propose to extend this work to examine the transition off treatment and into survivorship. Our aims are: 1) To examine continuity and change in parent-child communication about cancer; 2) To identify early predictors of later mental and physical health outcomes for children with cancer and their parents; and 3) To examine reciprocal relationships between parent and child coping, mental and physical health. To meet these aims, we propose to collect 2 additional waves of interview, observational and multi-agent questionnaire data spaced 12 months apart. The project is designed to identify risk and protective factors and processes that can be used to establish a theory-driven model of coping and adaptation to childhood cancer and to identify targets for the future early preventive psychosocial interventions with children with cancer and their parents.